NPI 1417377177

Familia Dental Los Lunas LLC

Organisation Dental Clinic/Center Los Lunas, NM

Practice location

Address: 1620 Main St NW STE D, Los Lunas, NM 87031-4891
Phone: (505) 565-0651
Fax: (505) 565-2031
Mailing address: 2050 East Algonquin Road Suite 610, Schaumburg, IL 60173-4166

Authorised official

Name: Brandon Alexander Taylor
Title: Credentialing & Payer Relations Man
Phone: (847) 453-7396

Registered specialties (2)

Dental Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QD0000X

Other Clinic/Center providers in New Mexico →

Dentist

Dental Providers Taxonomy 122300000X

Other Dentist providers in New Mexico →

Registry record

NPI: 1417377177
Entity type: Organization
NPI issued: 21 Apr 2014
Record last updated: 15 Oct 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.